Also, as an M3 I was useless. My notes didnt matter, I couldn’t put in orders and any procedure I did had to be supervised for liability reasons. Not to mention the general uselessness of an M3 to a surgical service fresh off his/her psych rotation lol. If you thought you were super awesome and more useful to the team than the people being paid to be there, please see the above bolded.
Are med students useless because they literally cannot help, or because we assume they can't and therefore don't let them?
Frankly, I think it's a mix.
Some med students are an asset to the team, and can be pretty damn helpful. A lot of medicine these days is grunt work, not complex decision making, but it still has to get done.
Was I useful as a medical student? Yes, on days where the system would let me and when I was on a service that wasn't loaded with 15 layers of people learning things. My surgery rotation had me on a busy vascular service with one chief, one intern, and me. The intern was often pulled elsewhere for call, etc., so there were days when the only person getting numbers, preparing presentations, and writing notes was me. And yes, we could use my notes, if they were attested/cosigned appropriately. The chief would have had a hell of a day running rounds without me, even just in that having 2 sets of hands for nasty vascular dressing changes is a boon.
When I was on trauma, I often went off and did wound cleaning/simple laceration repairs on my own without supervision. The resident would examine the wound first, sure, and at the beginning usually took a look at the final product. But they saved the time of gathering supplies and actually
doing the procedure.
On Psych, I usually wrote notes for the entire service which were used.
Of course, I've seen students who can't help out with gathering supplies because they need to be hand-held through finding gauze in a supply closet, or who never learn to present concisely. It's a crap-shoot.
Are med students
necessary? No. A system that has med students as the ultimate responsible party for
necessary work is doomed to fail because some med students won't/can't do it. But can they be helpful and useful? Absolutely. Can they decrease the work of the team? Yes. Can they do
some of the necessary work that otherwise would have to be done by the resident? Yes. As long as the system is set up to recognize this and allow it.
Administrators seem to think that if they let med students do work, nobody else will ever do it and quality will all suffer. That's bull...most teams I've been on ultimately care about the quality of the work that gets done, and will let students do as much as they have demonstrated an actual ability to do. I've never signed a med student note without reading and addending it, but my work load is lessened by only having to read and addend it.
The 'uselessness' comes in when the institution's attitude becomes "well, some med students write crappy notes, so we shouldn't let any of them write any notes that count even with attestation". This means that students are only
allowed to do useless duplications of actual work, and yet still require teaching and revision. Then I have to write a note
and read/edit the students' meaningless duplicate version, which is
extra work for me. In that system, I have extra work whether my student is good or bad (more, actually, if they're good and I have to review more notes), and the only way to save myself work is to ignore them and not teach.
In a system where the resident is ultimately responsible for the quality and completion of the work, but allowed to delegate to the student up to their discretion, a good student can decrease their workload, a bad one usually won't help much, and helping students
become good can decrease my workload in the long run.
